Prosmiles of Montana, LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Legal business name

PROSMILES OF MONTANA, LLC

Practice address

105 Grey Wolf TRL
Bozeman, MT 59718-7677

Phone

(406) 539-0894

NPI assigned

Nov 1, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cara Reck

Title

Co-Founder

Phone

(406) 539-0894

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1043854029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 GREY WOLF TRL",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187677",
            "telephone_number": "406-539-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GREY WOLF TRL",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187677",
            "telephone_number": "406-539-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSMILES OF MONTANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "RECK",
        "authorized_official_first_name": "CARA",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "406-539-0894"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.